defenses—the innate immune system—and spread to others quickly enough, in close quarters, among confined populations, it could overwhelm any more refined immune response and bring down a huge number of victims in days. He doubted that contact immunity could have had any influence in this outbreak. Another of Mother Nature’s little screwups. Or not. He still had a lot to unlearn when it came to viruses and disease, a lot of assumptions to reexamine.
Dicken needed to map the river of this illness before he would venture an answer, chart it back from whatever tributary they were at now to its source. He wanted to know the virus when it was asleep, what he called glacial virus—learn where it hid as frozen snow in the high valleys of the human and animal population, before it melted and became the torrent they were now seeing.
If he found anything closer to that ideal source, that beginning, things might fall into place. He might understand.
Or not.
What they all needed to know as a practical matter was whether this flood would jump its banks and find another run. Taking specimens from the staff would begin to answer that question. But he already had a gut feeling that this disease, attacking a new and juicy population, would not readily cross over to old style humans.
Proving that would, in any sane world, stop the political nightmare building outside.
They passed a crate of body bags the end of the loading dock.
“No trouble getting those,” Middleton said. “They’re going to be filled in a couple of hours.”
CHAPTER THIRTY-FOUR Pennsylvania
Mitch washed his face for the fourth or fifth time in the bathroom adjacent to the bedroom. He stared at the brass light fixtures, the antique gold faucets, the tile floor. He had never been much for luxuries, but it would have been nice to provide more than just a run-down shack in the Virginia countryside. They had been plagued by ants and by roaches. The big yard had been nice, though. He had liked to sit there with Stella and drag a string for the ever-willing Shamus.
The doctor arrived. He was in his early thirties, hair spiked and frosted. He looked very young. He wore a short-sleeved shirt and carried a black bag and a NuTest diagnostic unit the size of a data phone. He was as worn-out as they were, but he immediately inspected Stella. He took blood and sputum from the girl, who hardly noticed the prick of the little needle. The spit was harder to obtain; Stella’s mouth was as dry as a bone. He smeared these fluids on the business end of the NuTest arrays—little sheets of grooved plastic—then inserted them. A few minutes later, he read the results.
“It’s a virus,” he said. “A picornavirus. No surprise there. Some sort of enterovirus. A variety of Coxsackie, probably. But…” He looked at them with a quizzical, worried expression. “There are some polymorphisms that aren’t in the NuTest library. I can’t make a final determination here.”
“Were the baths the right thing to do?” Mitch asked.
“Absolutely,” the doctor said. “She’s four degrees elevated. Coming down, maybe, but it could spike again. Keep her cool, but don’t wear her down. She’s skin and bones now.”
“She’s naturally slender,” Kaye said.
“Good. She’ll grow up to be a model,” the doctor said.
“Not if I can help it,” Kaye said.
The doctor stared at Kaye. “Don’t I know you?”
“No,” she said. “You don’t.”
“Right,” the doctor said, coming to his senses. He gave Stella the first injection, a broad-spectrum antiviral with multiplex immunoglobulin and B vitamins. “Used these when measles hit a bunch of old kids in Lancaster,” he said, then grimaced and shook his head. “‘Old kids.’ Listen to me. We’re talking in tangles. This isn’t measles, but the shot can’t hurt. It’s only good in a series, however. I’ll report her arrays anonymously to Atlanta. Part of the field program. Completely anonymous.”
Mitch listened without reaction. He was almost beyond caring about anonymity. He looked up as the doctor glanced at the NuTest display and said, “Whoops. Shit.” The display was blinking rapidly, reflecting on the doctor’s face.
“What?”
“Nothing,” the doctor said, but Mitch thought he looked guilty, as if he had screwed up. “Can I have some of that coffee?” the doctor asked. “Cold is fine. I’ve got two more patients tonight.”
He felt Stella under her jaw and behind the ears, then turned her over and inspected her buttocks. A rash was forming on both cheeks. “She’s spiking again.” He turned her over and helped carry her to the bathtub. George had emptied the kitchen ice machine and driven off to get more from the local grocery. They sponged her down with cold tap water. Stella was convulsing by the time George returned.
Mitch lifted Stella out of the tub by her underarms, soaking his clothes. George emptied four bags of ice into the water. Then they lowered her in again.
“It’s too cold,” Stella shrieked thinly.
Mitch’s daughter seemed to weigh almost nothing. She was ephemeral. The illness was stealing her away so quickly he could not react.
The doctor left to get another injection ready.
Kaye held up her daughter’s hand. It was pale and blue. She saw small sores between the girl’s fingers. With a gasp, she dropped the hand and leaned to lift Stella’s foot. She showed the sole to Mitch. Small lesions spotted the flesh between Stella’s toes. “They’re on her hands, too,” Kaye said.
Mitch shook his head. “I don’t know what that is.”
George pushed back from the tub and stood, his face showing alarm. The doctor returned with another syringe. As he was injecting Stella he looked at the girl’s fingers and nodded. He pulled back Stella’s lips and looked into her mouth. Stella moaned.
“Could be herpangina, vesicular stomatitis—” He took a deep breath. “I can’t make the call here with just a NuTest. Treatment with a targeted antiviral would work best, and that requires a positive ID. That should be done in a reference lab, and she should be hospitalized. I just don’t have that kind of equipment.”
“No one will admit her,” George said. “Blanket ban.”
“Disgraceful,” the doctor said, his voice flat from exhaustion. He looked up at George. “It could be communicable. You’ll want to sterilize this bathroom and bleach the sheets.”
George nodded.
“There’s someone who might be able to help,” Mitch said to Kaye, taking her aside.
“Christopher?” Kaye asked.
“Call him. Ask him what’s happening. You know his phone number.”
“His home,” Kaye said. “It’s an old number. I’m not sure where he works now.”
The doctor had dialed up a sentinel CDC report page on his Web phone. “There’s no warning posted,” he said. “But I’ve never seen pediatric warnings for virus children.”
“New children,” George corrected.
“Is it a reportable disease?” Kaye asked.
“It’s not even listed,” the doctor said, but there was something in his face that disturbed Kaye. The NuTest. It’s got a GPS and a broadband hookup to the Department of Health. And from there, to NIH or the CDC. I’m sure of it.
But there was nothing they could do. She shrugged it off.
“Call,” Mitch told Kaye.
“I don’t know who he’s working for now,” Kaye said.